53378 1027 Pennington /
Tract No. 3994 Lot No.�
-a CITY OF SAN JOSE BUILDING DEPARTMENT
_ APPLICATION FOR BUILDING PERMITT337�o2�P�
Date —/2— 19 7 Permit No.
Application is hereby made for a permit +o
astory, Th�ee,e ldil ling4j.Use Zone ") O —b
at 7Q.27 rYFwx/InTG T N /y/- D��//i�v ,Qi¢T/O Occupancy Z
to be occupied only as / EA� �1� Parking Space
in accordance with Plans, Specifications a�1-plan file�d�KedreYwl,WOF`r'Sprinkler
J
Estimated Value of Improvements, $
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I shall not employ any person
inany anlier so as to violate aeffhorkmen's compensation laws of Calhifornia.
Ownermr//,A � d Q./-&L-n' �oAddress���d ��m
6y '-�f Address
:;^:1027 Pennington Sprague �_
99/5-W01-I-082 w,.j
09704S
BW@Jj UOI}@PUUOj
N01103dSN1 d0 C1100311